EDOT Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 7078 To study the effects of changes to telehealth under the Medicare and Medicaid programs during the COVID–19 emergency. IN THE HOUSE OF REPRESENTATIVES JUNE 1, 2020 Ms. KELLY of Illinois (for herself, Mr. BISHOP of Georgia, Ms. JACKSON LEE, Ms. SEWELL of Alabama, Mr. THOMPSON of Mississippi, Ms. FUDGE, Mr. BUTTERFIELD, Mr. PAYNE, Ms. LEE of California, and Mr. COHEN) introduced the following bill; which was referred to the Committee on En- ergy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdic- tion of the committee concerned A BILL To study the effects of changes to telehealth under the Medicare and Medicaid programs during the COVID– 19 emergency. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Evaluating Disparities 4 and Outcomes of Telehealth During the COVID–19 Emer- 5 gency Act of 2020’’ or the ‘‘EDOT Act of 2020’’. 6 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 7078 IH SEC. 2. STUDY ON THE EFFECTS OF CHANGES TO TELE- 1 HEALTH UNDER THE MEDICARE AND MED- 2 ICAID PROGRAMS DURING THE COVID–19 3 EMERGENCY. 4 (a) IN GENERAL.—Not later than 1 year after the 5 end of the emergency period described in section 6 1135(g)(1)(B) of the Social Security Act (42 U.S.C. 7 1320b–5(g)(1)(B)), the Secretary of Health and Human 8 Services (in this section referred to as the ‘‘Secretary’’) 9 shall conduct a study and submit to the Committee on 10 Energy and Commerce and the Committee on Ways and 11 Means of the House of Representatives and the Committee 12 on Finance of the Senate an interim report on any 13 changes made to the provision or availability of telehealth 14 services under part A or B of title XVIII of the Social 15 Security Act (42 U.S.C. 1395 et seq.) during such period. 16 Such report shall include the following: 17 (1) A summary of utilization of all health care 18 services furnished under such part A or B during 19 such period, including the number of telehealth visits 20 (broken down by the number of such visits furnished 21 via audio-visual technology, the number of such vis- 22 its furnished via audio-only technology, and the 23 number of such visits furnished by a Federally quali- 24 fied health center, rural health clinic, or community 25 health center, respectively, if practicable), in-person 26 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 7078 IH outpatient visits, inpatient admissions, and emer- 1 gency department visits. 2 (2) A description of any changes in utilization 3 patterns for the care settings described in paragraph 4 (1) over the course of such period compared to such 5 patterns prior to such period. 6 (3) An analysis of utilization of telehealth serv- 7 ices under such part A or B during such period, bro- 8 ken down by race and ethnicity, geographic region, 9 and income level (as measured directly or indirectly, 10 such as by patient’s zip code tabulation area median 11 income as publicly reported by the United States 12 Census Bureau), and of any trends in such utiliza- 13 tion during such period, so broken down. Such anal- 14 ysis may not include any personally identifiable in- 15 formation or protected health information. 16 (4) A description of expenditures and any sav- 17 ings under such part A or B attributable to use of 18 such telehealth services during such period. 19 (5) A description of any instances of fraud 20 identified by the Secretary, acting through the Office 21 of the Inspector General or other relevant agencies 22 and departments, with respect to such telehealth 23 services furnished under such part A or B during 24 such period and a comparison of the number of such 25 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 7078 IH instances with the number of instances of fraud so 1 identified with respect to in-person services so fur- 2 nished during such period. 3 (6) A description of any privacy concerns with 4 respect to the furnishing of such telehealth services 5 (such as cybersecurity or ransomware concerns), in- 6 cluding a description of any actions taken by the 7 Secretary, acting through the Health Sector Cyber- 8 security Coordination Center or other relevant agen- 9 cies and departments, during such period to assist 10 health care providers secure telecommunications sys- 11 tems. 12 (b) INPUT.—In conducting the study and submitting 13 the report under subsection (a), the Secretary— 14 (1) may— 15 (A) consult with relevant stakeholders 16 (such as patients, minority or tribal groups, 17 medical professionals, hospitals, State medical 18 boards, State nursing boards, the Federation of 19 State Medical Boards, National Council of 20 State Boards of Nursing, medical professional 21 employers (such as hospitals, medical groups, 22 staffing companies), telehealth groups, health 23 professional liability providers, public and pri- 24 vate payers, and State leaders); and 25 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 7078 IH (B) solicit public comments on such report 1 before the submission of such report; and 2 (2) shall endeavor to include as many racially, 3 ethnically, geographically, and professionally diverse 4 perspectives as possible. 5 (c) FINAL REPORT.—Not later than December 31, 6 2024, the Secretary shall— 7 (1) update and finalize the interim report under 8 subsection (a); and 9 (2) submit such updated and finalized report to 10 the committees specified in such subsection. 11 (d) GRANTS FOR MEDICAID REPORTS.— 12 (1) IN GENERAL.—Not later than 2 years after 13 the end of the emergency period described in section 14 1135(g)(1)(B) of the Social Security Act (42 15 U.S.C.1320b–5(g)(1)(B)), the Secretary shall award 16 grants to States with a State plan (or waiver of such 17 plan) in effect under title XIX of the Social Security 18 Act (42 U.S.C. 1396r) that submit an application 19 under this subsection for purposes of enabling such 20 States to study and submit reports to the Secretary 21 on any changes made to the provision or availability 22 of telehealth services under such plans (or such 23 waivers) during such period. 24 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 7078 IH (2) ELIGIBILITY.—To be eligible to receive a 1 grant under paragraph (1), a State shall— 2 (A) provide benefits for telehealth services 3 under the State plan (or waiver of such plan) 4 in effect under title XIX of the Social Security 5 Act (42 U.S.C. 1396r); 6 (B) be able to differentiate telehealth from 7 in-person visits within claims data submitted 8 under such plan (or such waiver) during such 9 period; and 10 (C) submit to the Secretary an application 11 at such time, in such manner, and containing 12 such information (including the amount of the 13 grant requested) as the Secretary may require. 14 (3) USE OF FUNDS.—An State shall use 15 amounts received under a grant under this sub- 16 section to conduct a study and report findings re- 17 garding the effects of changes to telehealth services 18 offered under the State plan (or waiver of such plan) 19 of such State under title XIX of the Social Security 20 Act (42 U.S.C. 1396 et seq.) during such period in 21 accordance with paragraph (4). 22 (4) REPORTS.— 23 (A) INTERIM REPORT.—Not later 1 year 24 after the date a State receives a grant under 25 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 7078 IH this subsection, the State shall submit to the 1 Secretary an interim report that— 2 (i) details any changes made to the 3 provision or availability of telehealth bene- 4 fits (such as eligibility, coverage, or pay- 5 ment changes) under the State plan (or 6 waiver of such plan) of the State under 7 title XIX of the Social Security Act (42 8 U.S.C. 1396 et seq.) during the emergency 9 period described in paragraph (1); and 10 (ii) contains— 11 (I) a summary and description of 12 the type described in paragraphs (1) 13 and (2), respectively, of subsection 14 (a); and 15 (II) to the extent practicable, an 16 analysis of the type described in para- 17 graph (3) of subsection (a), 18 except that any reference in such sub- 19 section to ‘‘such part A or B’’ shall, for 20 purposes of subclauses (I) and (II), be 21 treated as a reference to such State plan 22 (or waiver). 23 (B) FINAL REPORT.—Not later than 3 24 years after the date a State receives a grant 25 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 7078 IH under this subsection, the State shall update 1 and finalize the interim report and submit such 2 final report to the Secretary. 3 (C) REPORT BY SECRETARY.—Not later 4 than the earlier of the date that is 1 year after 5 the submission of all final reports under sub- 6 paragraph (B) and December 31, 2028, the 7 Secretary shall submit to Congress a report on 8 the grant program, including a summary of the 9 reports received from States under this para- 10 graph. 11 (5) MODIFICATION AUTHORITY.—The Secretary 12 may modify any deadline described in paragraph (4) 13 or any information required to be included in a re- 14 port made under this subsection to provide flexibility 15 for States to modify the scope of the study and 16 timeline for such reports. 17 (6) TECHNICAL ASSISTANCE.—The Secretary 18 shall provide such technical assistance as may be 19 necessary to a State receiving a grant under this 20 subsection in order to assist such state in conducting 21 studies and submitting reports under this sub- 22 section. 23 (7) STATE.—For purposes of this subsection, 24 the term ‘‘State’’ means each of the several States, 25 VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 7078 IH the District of Columbia, and each territory of the 1 United States. 2 (e) AUTHORIZATION OF APPROPRIATIONS.— 3 (1) MEDICARE.—For the purpose of carrying 4 out subsections (a) through (c), there are authorized 5 to be appropriated such sums as may be necessary 6 for each of the fiscal years 2020 through 2024. 7 (2) MEDICAID.—For the purpose of carrying 8 out subsection (d), there are authorized to be appro- 9 priated such sums as may be necessary for each of 10 the fiscal years 2022 through 2028. 11 Æ VerDate Sep 11 2014 07:34 Jun 23, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\H7078.IH H7078 kjohnson on DSK79L0C42PROD with BILLS